Why do we need a new model?
The goal for developing the Consensus Model is to achieve greater congruence in licensure, accreditation, certification and education in order to reduce the confusion and inconsistency that currently exists in advanced practice nursing.
What does LACE stand for?
Licensure, accreditation, certification and education
The purpose of LACE is to promote the adoption of the Consensus Model.
Was APNA involved in the development of this model? And why did APNA endorse it?
Yes, APNA was actively involved in the development of this model.
We endorsed the model because we felt that it represented the best opportunities for PMH advanced practice nurses in the future.
Does this model only apply to nurse practitioners?
No, this model applies to all advanced practice nurses who provide direct patient care.
What will happen to my current licensure and certification with the adoption of the Consensus Model?
If you are certified and licensed in a state, you will not be impacted by the Consensus Model. However, if you move to another state, you must meet the eligibility requirements of that state that are in effect at the time you moved to the state. At the time you move, the state board of nursing will look at the education you had to determine if you meet those current requirements.
The goal of the Consensus Model is greater consistency across states so that advanced practice nurses do not continue to experience these portability issues, but that goal may take a while to be reached. Achieving this consistency may require changes in state nurse practice acts or changes in state rules and regulations.
If you are interested in current state licensure requirements, go to APNA.org and Resources, for a guide to applications in each state.
With the implementation of this Model, will I be more independent as an advanced practice nurse?
If you read the Consensus paper carefully, the implication is to work toward autonomy for all direct care advanced practice nurses in all roles and all states. If this comes to fruition, there will be fewer restrictions for both NPs and CNSs.
How do the National Council of State Boards of Nursing (NCSBN) and the state boards of nursing feel about the consensus model?
NCSBN was actively involved in the development of the Consensus Model and endorses it.
The state boards of nursing are also supportive of the model, but the nurse practice acts or rules and regulations of each state may need to change to reflect that approval. This will take time.
Does the Consensus Model affect PMH scope and standards?
No, the PMH scope and standards for both the CNS and NP will remain intact unless we (PMH nurses) decide they need updating.
Doesn’t this new model devalue the CNS?
No, in fact, the consensus model clearly articulates the CNS as a distinct role and is valued as a separate role.
In PMH nursing there has been some overlap in the two roles and some overlap will probably continue into the future. However, new CNS graduates will need to meet the CNS competencies as outlined by NACNS, just as new NP graduates need to meet the NP competencies.
What does this new Model mean in terms of educational programs?
Since the basic advanced practice PMH NP and CNS education will have a lifespan approach, some programs may need to change. How and the degree to which they change will be discussed within the profession.
Why should we take a lifespan approach at the level of licensure?
Licensure using the lifespan approach protects both PMH advanced practice nurses and patients. APNA and ISPN have convened a joint task force to assess and recommend how LACE will be implemented for psychiatric mental health nursing - lifespan is a major topic of that group. Check the APNA website periodically for updates.
But doesn’t this mean that graduating APRNs will not have the skills they need to treat children/adolescents or adults or older adults? How can one be competent with all age groups?
This is a question that we as a profession need to sort out. As noted above, APNA and ISPN have convened a task force to assess and recommend how LACE will be implemented for psychiatric mental health nursing. The skills that one will need are being addressed by the task force. Check the APNA website periodically for updates.
How does specialty education fit into all of this? Isn’t psychiatric nursing a specialty?
For the purposes of this Model, psychiatric mental health nursing is being defined as a population. So, for basic licensure an advanced practice nurse will need to have been educated in a role and a population.
A specialty is similar to what we often term a subspecialty. Examples are child/adolescent psych, geropsych, substance abuse, etc. This would signify further education above the basic level.
How does the consensus model fit with the DNP?
The American Association of Colleges of Nursing has recommended that all specialty education be at the DNP level by 2015. This recommendation was independent of the work on the Consensus Model, but does not contradict the Consensus Model.
The Consensus Model paper refers to graduate education at the masters, post-master’s and doctoral level.
How does all this fit with the Clinical Nurse Leader?
The CNL will have a master’s degree, but the course content is not in any specialty area. The CNL graduate cannot sit for CNS or NP certification exams.
What do I do if I want to go to a graduate program or, if I’m already a CNS and I would like to be an NP?
APNA has a list of graduate programs on the website. You can also go to allnursingschools.com. From there you can explore different schools’ websites to see what fits your needs.